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Home Pretreatment Detection, Surveillance, and Staging of Prostate Cancer
Variants
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Prostate cancer, high risk, staging 3196078
MRI abdomen and pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Bone scan whole body
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Choline PET/CT skull base to mid-thigh
1-10 mSv
☢☢☢
Usually appropriate
Choline PET/MRI skull base to mid-thigh
1-10 mSv
☢☢☢
Usually appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Fluciclovine PET/MRI skull base to mid-thigh
1-10 mSv
☢☢☢
Usually appropriate
CT chest abdomen pelvis with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Fluciclovine PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢
Usually appropriate
Fluoride PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
PSMA PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢
Usually appropriate
MRI abdomen and pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI whole body without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI whole body without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		May be appropriate
(Disagreement)
CT chest abdomen pelvis without IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MRI-targeted biopsy prostate
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
TRUS prostate
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
TRUS-guided biopsy prostate
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
FDG-PET/MRI skull base to mid-thigh
1-10 mSv
☢☢☢
Usually not appropriate
CT chest abdomen pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
FDG-PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate